The Flexion-Type Supracondylar Humeral Fracture in Children: A Review.

Abstract

» A flexion supracondylar fracture of the humerus is an uncommon fracture in children and accounts for only 1% to 10% of all supracondylar fractures.» The injury is caused by a direct fall on the point of the elbow, causing hyperflexion at the elbow, rather than by a fall on an outstretched hand, which is the mechanism in an extension-type fracture.» The ulnar nerve is at higher risk of injury in this fracture by the spike of the proximal fragment or by entrapment in the callus.» This fracture is inherently unstable, leading to difficulty in maintaining reduction intraoperatively and difficult Kirschner wiring in the extension position in which the reduction is achieved.» Kirschner wiring can be done in a flexed position of the elbow by utilizing a push-pull method, a temporary transolecranon pin, or a Kirschner wire as a joystick in the distal fragment to achieve and maintain reduction before the insertion of the final pins.